Admission factors associated with prolonged (> 14 days) intensive care unit stay
Abstract Purpose To describe the admission factors associated with prolonged (> 14 days) intensive care unit (ICU) stay (PIS). Materials and Methods Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant var...
Gespeichert in:
| Veröffentlicht in: | Journal of critical care 2014-02, Vol.29 (1), p.60-65 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 65 |
|---|---|
| container_issue | 1 |
| container_start_page | 60 |
| container_title | Journal of critical care |
| container_volume | 29 |
| creator | Zampieri, Fernando Godinho, MD Ladeira, José Paulo, MD Park, Marcelo, MD, PhD Haib, Douglas, MD Pastore, Cintia Lovatto, ANP Santoro, Cristiane M., ANP Colombari, Fernando, MD |
| description | Abstract Purpose To describe the admission factors associated with prolonged (> 14 days) intensive care unit (ICU) stay (PIS). Materials and Methods Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant variables and PIS (> 14 days) through binary logistic regression using the backward method. A Kaplan-Meier curve and the log-rank test were used to compare hospital outcomes for ICU survivors between patients with and without PIS. Results In total, 6.6% of all admissions had a prolonged stay, consuming over 40% of all ICU bed-days. Illness severity; respiratory support at admission; performance status; readmission; admission from a ward, emergency room or other hospital; admission due to intracranial mass effect; severe chronic obstructive pulmonary disease; and the temperature at admission were all associated with PIS in a multivariate analysis. The created model had a good area under the curve (0.82) and was calibrated (Hosmer-Lemeshow test p = 0.431). Post hoc analysis on ICU survivors on in patients with at least two days of ICU stay yielded similar results. Hospital survival after ICU discharge was similar for patients with and without PIS (log-rank test p = 0.50). Conclusion A small number of ICU admissions consume a great proportion of ICU bed-days. Illness severity, a need for support and performance status are important predictors of PIS. Patients who survive a PIS have similar hospital mortality to patients with a shorter stay. |
| doi_str_mv | 10.1016/j.jcrc.2013.09.030 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1523399067</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883944113003857</els_id><sourcerecordid>1523399067</sourcerecordid><originalsourceid>FETCH-LOGICAL-c472t-e5d564bf315bd8ec9a8257050e5b4648b262da189e8ba8a425f562c4e22847863</originalsourceid><addsrcrecordid>eNqFks1rFTEUxYMo9ln9B1xIwE1dzJjvyYAUSvELCgrqOmSSO5pxXlKTmcr7783wqkIXugqB3zncc89F6CklLSVUvZzayWXXMkJ5S_qWcHIP7aiUXaMVlffRjmjNm14IeoIelTIRQjvO5UN0wgRTWjG2Qx8v_D6UElLEo3VLygXbUpILdgGPf4blG77OaU7xa_2enWMqsLeH8gKHuEAs4QawsxnwGsOCy2IPj9GD0c4Fnty-p-jLm9efL981Vx_evr-8uGqc6NjSgPRSiWHkVA5eg-utZrIjkoAchBJ6YIp5S3UPerDaCiZHqZgTwJgWnVb8FJ0dfet4P1Yoi6k5HMyzjZDWYqhknPc9Ud3_UdF1dRhKWUWf30GntOZYg1SqWkkhiK4UO1Iup1IyjOY6h73NB0OJ2aoxk9mqMVs1hvSmVlNFz26t12EP_o_kdxcVeHUEoK7tJkA2xQWIDnzI4BbjU_i3__kduZtDDM7O3-EA5W8OU5gh5tN2HNttUE4I17LjvwCemrF2</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1467354408</pqid></control><display><type>article</type><title>Admission factors associated with prolonged (> 14 days) intensive care unit stay</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Zampieri, Fernando Godinho, MD ; Ladeira, José Paulo, MD ; Park, Marcelo, MD, PhD ; Haib, Douglas, MD ; Pastore, Cintia Lovatto, ANP ; Santoro, Cristiane M., ANP ; Colombari, Fernando, MD</creator><creatorcontrib>Zampieri, Fernando Godinho, MD ; Ladeira, José Paulo, MD ; Park, Marcelo, MD, PhD ; Haib, Douglas, MD ; Pastore, Cintia Lovatto, ANP ; Santoro, Cristiane M., ANP ; Colombari, Fernando, MD</creatorcontrib><description>Abstract Purpose To describe the admission factors associated with prolonged (> 14 days) intensive care unit (ICU) stay (PIS). Materials and Methods Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant variables and PIS (> 14 days) through binary logistic regression using the backward method. A Kaplan-Meier curve and the log-rank test were used to compare hospital outcomes for ICU survivors between patients with and without PIS. Results In total, 6.6% of all admissions had a prolonged stay, consuming over 40% of all ICU bed-days. Illness severity; respiratory support at admission; performance status; readmission; admission from a ward, emergency room or other hospital; admission due to intracranial mass effect; severe chronic obstructive pulmonary disease; and the temperature at admission were all associated with PIS in a multivariate analysis. The created model had a good area under the curve (0.82) and was calibrated (Hosmer-Lemeshow test p = 0.431). Post hoc analysis on ICU survivors on in patients with at least two days of ICU stay yielded similar results. Hospital survival after ICU discharge was similar for patients with and without PIS (log-rank test p = 0.50). Conclusion A small number of ICU admissions consume a great proportion of ICU bed-days. Illness severity, a need for support and performance status are important predictors of PIS. Patients who survive a PIS have similar hospital mortality to patients with a shorter stay.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2013.09.030</identifier><identifier>PMID: 24268622</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Aged ; Aged, 80 and over ; Blood diseases ; Brazil ; Chronic obstructive pulmonary disease ; Comorbidity ; Critical Care ; Critical Illness ; Emergency medical care ; Female ; Heart failure ; Hemodialysis ; Hospital Mortality ; Hospitals ; Humans ; Intensive care ; Intensive Care Units - statistics & numerical data ; Kaplan-Meier Estimate ; Length of Stay - statistics & numerical data ; Male ; Medical prognosis ; Middle Aged ; Mortality ; Nursing homes ; Oxygen therapy ; Patient Admission - statistics & numerical data ; Patient Readmission - statistics & numerical data ; Patients ; Performance status ; Prolonged ICU stay ; Respiration, Artificial - statistics & numerical data ; Retrospective Studies ; Severity of Illness Index ; Tertiary Care Centers - statistics & numerical data ; Time Factors ; Treatment Outcome ; Variables ; Ventilation]]></subject><ispartof>Journal of critical care, 2014-02, Vol.29 (1), p.60-65</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-e5d564bf315bd8ec9a8257050e5b4648b262da189e8ba8a425f562c4e22847863</citedby><cites>FETCH-LOGICAL-c472t-e5d564bf315bd8ec9a8257050e5b4648b262da189e8ba8a425f562c4e22847863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1467354408?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994,64384,64386,64388,72340</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24268622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zampieri, Fernando Godinho, MD</creatorcontrib><creatorcontrib>Ladeira, José Paulo, MD</creatorcontrib><creatorcontrib>Park, Marcelo, MD, PhD</creatorcontrib><creatorcontrib>Haib, Douglas, MD</creatorcontrib><creatorcontrib>Pastore, Cintia Lovatto, ANP</creatorcontrib><creatorcontrib>Santoro, Cristiane M., ANP</creatorcontrib><creatorcontrib>Colombari, Fernando, MD</creatorcontrib><title>Admission factors associated with prolonged (> 14 days) intensive care unit stay</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose To describe the admission factors associated with prolonged (> 14 days) intensive care unit (ICU) stay (PIS). Materials and Methods Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant variables and PIS (> 14 days) through binary logistic regression using the backward method. A Kaplan-Meier curve and the log-rank test were used to compare hospital outcomes for ICU survivors between patients with and without PIS. Results In total, 6.6% of all admissions had a prolonged stay, consuming over 40% of all ICU bed-days. Illness severity; respiratory support at admission; performance status; readmission; admission from a ward, emergency room or other hospital; admission due to intracranial mass effect; severe chronic obstructive pulmonary disease; and the temperature at admission were all associated with PIS in a multivariate analysis. The created model had a good area under the curve (0.82) and was calibrated (Hosmer-Lemeshow test p = 0.431). Post hoc analysis on ICU survivors on in patients with at least two days of ICU stay yielded similar results. Hospital survival after ICU discharge was similar for patients with and without PIS (log-rank test p = 0.50). Conclusion A small number of ICU admissions consume a great proportion of ICU bed-days. Illness severity, a need for support and performance status are important predictors of PIS. Patients who survive a PIS have similar hospital mortality to patients with a shorter stay.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood diseases</subject><subject>Brazil</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Comorbidity</subject><subject>Critical Care</subject><subject>Critical Illness</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Heart failure</subject><subject>Hemodialysis</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Kaplan-Meier Estimate</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nursing homes</subject><subject>Oxygen therapy</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Patients</subject><subject>Performance status</subject><subject>Prolonged ICU stay</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Variables</subject><subject>Ventilation</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks1rFTEUxYMo9ln9B1xIwE1dzJjvyYAUSvELCgrqOmSSO5pxXlKTmcr7783wqkIXugqB3zncc89F6CklLSVUvZzayWXXMkJ5S_qWcHIP7aiUXaMVlffRjmjNm14IeoIelTIRQjvO5UN0wgRTWjG2Qx8v_D6UElLEo3VLygXbUpILdgGPf4blG77OaU7xa_2enWMqsLeH8gKHuEAs4QawsxnwGsOCy2IPj9GD0c4Fnty-p-jLm9efL981Vx_evr-8uGqc6NjSgPRSiWHkVA5eg-utZrIjkoAchBJ6YIp5S3UPerDaCiZHqZgTwJgWnVb8FJ0dfet4P1Yoi6k5HMyzjZDWYqhknPc9Ud3_UdF1dRhKWUWf30GntOZYg1SqWkkhiK4UO1Iup1IyjOY6h73NB0OJ2aoxk9mqMVs1hvSmVlNFz26t12EP_o_kdxcVeHUEoK7tJkA2xQWIDnzI4BbjU_i3__kduZtDDM7O3-EA5W8OU5gh5tN2HNttUE4I17LjvwCemrF2</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Zampieri, Fernando Godinho, MD</creator><creator>Ladeira, José Paulo, MD</creator><creator>Park, Marcelo, MD, PhD</creator><creator>Haib, Douglas, MD</creator><creator>Pastore, Cintia Lovatto, ANP</creator><creator>Santoro, Cristiane M., ANP</creator><creator>Colombari, Fernando, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Admission factors associated with prolonged (> 14 days) intensive care unit stay</title><author>Zampieri, Fernando Godinho, MD ; Ladeira, José Paulo, MD ; Park, Marcelo, MD, PhD ; Haib, Douglas, MD ; Pastore, Cintia Lovatto, ANP ; Santoro, Cristiane M., ANP ; Colombari, Fernando, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-e5d564bf315bd8ec9a8257050e5b4648b262da189e8ba8a425f562c4e22847863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood diseases</topic><topic>Brazil</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Comorbidity</topic><topic>Critical Care</topic><topic>Critical Illness</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Heart failure</topic><topic>Hemodialysis</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Kaplan-Meier Estimate</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nursing homes</topic><topic>Oxygen therapy</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Patients</topic><topic>Performance status</topic><topic>Prolonged ICU stay</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zampieri, Fernando Godinho, MD</creatorcontrib><creatorcontrib>Ladeira, José Paulo, MD</creatorcontrib><creatorcontrib>Park, Marcelo, MD, PhD</creatorcontrib><creatorcontrib>Haib, Douglas, MD</creatorcontrib><creatorcontrib>Pastore, Cintia Lovatto, ANP</creatorcontrib><creatorcontrib>Santoro, Cristiane M., ANP</creatorcontrib><creatorcontrib>Colombari, Fernando, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zampieri, Fernando Godinho, MD</au><au>Ladeira, José Paulo, MD</au><au>Park, Marcelo, MD, PhD</au><au>Haib, Douglas, MD</au><au>Pastore, Cintia Lovatto, ANP</au><au>Santoro, Cristiane M., ANP</au><au>Colombari, Fernando, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Admission factors associated with prolonged (> 14 days) intensive care unit stay</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>29</volume><issue>1</issue><spage>60</spage><epage>65</epage><pages>60-65</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose To describe the admission factors associated with prolonged (> 14 days) intensive care unit (ICU) stay (PIS). Materials and Methods Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant variables and PIS (> 14 days) through binary logistic regression using the backward method. A Kaplan-Meier curve and the log-rank test were used to compare hospital outcomes for ICU survivors between patients with and without PIS. Results In total, 6.6% of all admissions had a prolonged stay, consuming over 40% of all ICU bed-days. Illness severity; respiratory support at admission; performance status; readmission; admission from a ward, emergency room or other hospital; admission due to intracranial mass effect; severe chronic obstructive pulmonary disease; and the temperature at admission were all associated with PIS in a multivariate analysis. The created model had a good area under the curve (0.82) and was calibrated (Hosmer-Lemeshow test p = 0.431). Post hoc analysis on ICU survivors on in patients with at least two days of ICU stay yielded similar results. Hospital survival after ICU discharge was similar for patients with and without PIS (log-rank test p = 0.50). Conclusion A small number of ICU admissions consume a great proportion of ICU bed-days. Illness severity, a need for support and performance status are important predictors of PIS. Patients who survive a PIS have similar hospital mortality to patients with a shorter stay.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24268622</pmid><doi>10.1016/j.jcrc.2013.09.030</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0883-9441 |
| ispartof | Journal of critical care, 2014-02, Vol.29 (1), p.60-65 |
| issn | 0883-9441 1557-8615 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1523399067 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Aged Aged, 80 and over Blood diseases Brazil Chronic obstructive pulmonary disease Comorbidity Critical Care Critical Illness Emergency medical care Female Heart failure Hemodialysis Hospital Mortality Hospitals Humans Intensive care Intensive Care Units - statistics & numerical data Kaplan-Meier Estimate Length of Stay - statistics & numerical data Male Medical prognosis Middle Aged Mortality Nursing homes Oxygen therapy Patient Admission - statistics & numerical data Patient Readmission - statistics & numerical data Patients Performance status Prolonged ICU stay Respiration, Artificial - statistics & numerical data Retrospective Studies Severity of Illness Index Tertiary Care Centers - statistics & numerical data Time Factors Treatment Outcome Variables Ventilation |
| title | Admission factors associated with prolonged (> 14 days) intensive care unit stay |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T06%3A58%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Admission%20factors%20associated%20with%20prolonged%20(%3E%2014%20days)%20intensive%20care%20unit%20stay&rft.jtitle=Journal%20of%20critical%20care&rft.au=Zampieri,%20Fernando%20Godinho,%20MD&rft.date=2014-02-01&rft.volume=29&rft.issue=1&rft.spage=60&rft.epage=65&rft.pages=60-65&rft.issn=0883-9441&rft.eissn=1557-8615&rft_id=info:doi/10.1016/j.jcrc.2013.09.030&rft_dat=%3Cproquest_cross%3E1523399067%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1467354408&rft_id=info:pmid/24268622&rft_els_id=S0883944113003857&rfr_iscdi=true |